Evaluate and support airway, breathing, and circulation. Children may be more vulnerable to corrosive agents than adults because of the smaller diameter of their airways. In cases of respiratory compromise secure airway and respiration via endotracheal intubation. If not possible, perform cricothyroidotomy if equipped and trained to do so.
Use extreme caution when treating patients who have bronchospasm with aerosolized bronchodilators. The use of bronchial sensitizing agents in situations of multiple chemical exposures may pose additional risks. Consider the health of the myocardium before choosing which type of bronchodilator should be administered. Cardiac sensitizing agents may be appropriate; however, the use of cardiac sensitizing agents after exposure to certain chemicals may pose enhanced risk of cardiac arrhythmias (especially in the elderly). Wherever possible avoid the use of sympathomimetics in benzene exposed patients. Try to avoid administering epinephrine due to the possible myocardial sensitizing effect of benzene.
Patients who are hypotensive or have seizures should be treated in the conventional manner.
In the patient who has suffered from seizures, coma, or cardiac arrhythmia evaluate for acidosis and treat appropriately by administering intravenously sodium bicarbonate (initial adult dose = 1 ampule; pediatric dose = 1 Eq/kg). Further bicarbonate therapy should be guided by arterial blood gas measurements.